PubMed Health⌕ Search

Biomedical subjects

A Heimdahl

Publications and source records attributed to A Heimdahl.

At least 55 records · Page 3Linked to original sources
PubMed1990

Oral yeast infections in immunocompromised and seriously diseased patients.

The number of immunocompromised patients has increased during recent years. Most fungal infections in these patients are caused by Candida, Aspergillus, Mucor, and Cryptococcus species. Patients with low granulocyte count are at the highest risk of invasive candidal infection. The commonest type of granulocytopenia is observed in connection with malignant diseases of the hematopoietic system. Cytotoxic treatment and radiotherapy of large-body areas tend to produce a significant decrease in circulating granulocytes. Early diagnosis and adequate treatment of fungal infections are mandatory for a successful outcome. In the oral cavity it is important to differentiate between colonization and invasive infection. The optimal approach to diagnosis is a combination of histology and cultivation of specimens obtained from the same site of suspected infection. Prophylaxis of oral fungal infection in immunocompromised patients is generally aimed at preventing colonization.

Agranulocytosis↗
PubMed1990

Antimicrobial prophylaxis in oral surgery.

Postsurgical infections after oral surgery in healthy patients are almost exclusively wound infections caused by aerobic and anaerobic microorganisms endogenous to the oral cavity. Available data indicate that, in otherwise healthy patients, infectious complications after dentoalveolar surgery are decreased after penicillin prophylaxis. However, prophylaxis is still not recommended as a routine procedure, because wound infections are generally mild and easy to deal with. In maxillofacial surgery evidence exists that short term prophylaxis is preferable to long term; however, no definite proof is available to indicate that prophylaxis is preferable at all. In patients with locally or systemically reduced defence mechanisms, antimicrobial prophylaxis is generally advocated. Best defined regimens for antimicrobial prophylaxis in oral surgery concern patients at the risk of endocarditis, while guidelines still have an empiric base in immunocompromised patient groups.

Anti-Bacterial Agents↗
PubMed1989

The oral cavity as a port of entry for early infections in patients treated with bone marrow transplantation.

Before treatment of 181 patients with bone marrow transplantation (BMT) for leukemia, severe aplastic anemia, or metabolic disorders, the oral condition was examined clinically and roentgenologically. Fifty-three patients (29%) had chronic dental infections (osteitis) that needed treatment before BMT. In 10 of 181 cases (6%), BMT was postponed because of oral infections. Septicemia during the neutropenic phase was caused by oral microorganisms (alpha streptococci) in 24 of 59 (41%) patients with microbiologically proven septicemia. Septicemia with alpha streptococci was associated with graft-versus-host disease prophylaxis with methotrexate and subsequent increased frequency of oral ulcerations. No difference was observed in the frequency of reactivation of latent herpes simplex virus infection between different graft-versus-host disease prophylaxis regimens. Reactivation was more frequent in patients conditioned with total body irradiation than in patients conditioned without total body irradiation. Antiviral prophylaxis, with subsequent decreased frequency of oral herpes simplex reactivation, appeared to contribute to a low frequency of septicemia with alpha streptococci.

Adolescent↗
PubMed1989

Oropharyngeal colonisation with fungi and gram-negative rods in patients treated with radiotherapy of the head and neck.

Twenty-five patients treated for malignant conditions of the head and neck were investigated for the development of oral radiation mucositis as well as oropharyngeal colonisation with fungi and Gram-negative bacilli. The colonisation rate of the patients increased from 20% to 80% during therapy. The patients were colonised mainly with fungi, but also to a lesser extent with Gram-negative bacilli. During radiotherapy free volatile fatty acids in saliva were determined by direct gas-liquid chromatography. The amounts of acetic, butyric and propionic acid decreased during radiotherapy and remained at low levels 6 months after therapy. Radiation induced mucositis was observed in 28% of the patients after 1 week of irradiation. After 3 weeks of therapy all patients showed varying grades of mucositis. In seven of the 19 survivors (36%) erythema was still present 6 months after radiotherapy.

Adult↗
PubMed1989

Pathological changes related to long-term impaction of third molars. A radiographic study.

Pathological changes related to impacted 3rd molars (ITM) were studied in a radiographic investigation of 2128 randomly selected patients. In radiographs from 644 patients, 1211 ITM were noted. Pathological changes were observed in 25 of 477 (5.2%) maxillary ITM and in 59 of 734 (8%) mandibular ITM. A pathologically widened pericoronal space (indicating a dentigerous cyst) was observed in 5 of 477 maxillary and 43 of 734 mandibular ITM (p less than 0.001). Other pathologic changes observed were resorption of the 2nd molars (1% in the maxilla, 1.5% in the mandible) or loss of marginal bone on the distal aspect of the second molars (4% in the maxilla, 1% in the mandible). The risk of pathological sequelae because of ITM, apparently, is low. Prophylactic surgical removal should, therefore, be regarded with some reserve, particularly in view of the high frequency of deep impactions, with greater risk for surgical complications.

Adult↗
PubMed1989

Facial growth and morphology in long-term survivors after bone marrow transplantation.

A roentgen cephalometric investigation was used to study facial growth and morphology in 17 children who had undergone bone marrow transplantation (BMT) because of acute leukaemia and aplastic anaemia. The ages at BMT varied from 1.0 to 12.9 years. Preoperative treatment included high doses of cyclophosphamide and in children with acute leukaemia also 10 Gy total body irradiation (TBI). The median observation period following BMT was 3.9 years. The control group comprised 85 age and sex matched healthy children. In comparison to the controls, all linear measurements studied were found to be significantly diminished in children conditioned with TBI. For variables describing vertical dimensions, the degree of reduction appeared to be associated with the patients' ages at the time of irradiation. It was concluded that the disturbance in dental development, which is also a consequence of TBI, could be partly responsible for this association. Children who were not conditioned with TBI exhibited no significant differences when compared to controls in respect of the variables studied.

Bone Marrow Transplantation↗
PubMed1989

Oral mucous membrane lesions in children treated with bone marrow transplantation.

Oral mucous membrane lesions were studied in 54 children below 12 yr of age treated with allogeneic bone marrow transplantation mainly because of hematological malignancies. Sixty-two percent of the children exhibited a wide range of oral side effects during therapy. Lesions observed during the first 2 wk prior to engraftment of the donor marrow were related to the chemo- and radiotherapy given. Oral ulcerations were seen in 34% of the children. Children given methotrexate as graft-versus-host disease (GVHD) prophylaxis exhibited oral ulcerations significantly (P less than 0.05) more often than those given cyclosporin. Oral lesions related to acute GVHD were only observed in two patients. Reactivating herpes simplex virus infection was seen in 35% of the children who were seropositive prior to BMT. An extensive oral candidiasis was observed in 15% of the patients. All six children with a chronic GVHD exhibited changes in the oral mucosa 2-4 yr after transplantation such as erythma of the mucous membranes, tongue atrophy and also lichenoid changes in the buccal mucosa.

Antineoplastic Agents↗
PubMed1989

Effect of chemotherapy on dental maturity in children with hematological malignancies.

Dental maturity or dental age was determined in 44 children with hematological malignancies treated with chemotherapy. No significant difference was observed between the chronological and dental age in children treated with chemotherapy compared to healthy controls. With regard to the number of erupted permanent teeth, no significant differences could be found between the two groups. The results indicate that chemotherapy given to children with hematological malignancies did not interfere with dental maturity or eruption of permanent teeth.

Adolescent↗
PubMed1989

New trends in antibiotic prophylaxis of infective endocarditis in patients undergoing surgery in the oral cavity.

Viridans-streptococci, which normally reside in the oral cavity, are still the most common pathogens in infective endocarditis. During surgical procedures in the oral cavity, pharynx and respiratory tract, microorganisms may disseminate into the blood and cause infective endocarditis in predisposed patients. It is, therefore generally considered that these patients should be protected during surgery by an effective and simple antibiotic regimen. During recent years new recommendations for prevention of endocarditis have been presented in several countries. Single high dose amoxycillin or 2-dose phenoxymethylpenicillin are used in normal risk patients while 2-dose erythromycin or single high dose clindamycin may be used in patients allergic to penicillins. Parental agents are usually recommended in high risk patients with prosthetic heart valves, however, some countries prefer to administer peroral prophylaxis. Topical prophylaxis in the oral cavity is not included in any national recommendation, but may decrease the magnitude, as well as the frequency, of postsurgical bacteremia. Commonly used antiseptics such as chlorhexidine are not selective enough and causes overgrowth of some viridans-streptococci. More selectively acting agents, such as topical vancomycin, appear to be more suitable.

Anti-Bacterial Agents↗
PubMed1989

[Study on the formation of experimental infected rabbit].

The purpose of the present study is to produce a model of infections of oral cavity by inducing abscess in the mandibla of New Zealand White rabbits as close to the oral cavity infection site as possible in order to determine whether the administered antimicrobial agents will transfer to the localized inflammatory foci. The pus to be collected should be 0.5 to 1.0g or more to permit bioassay and it should be collectable under nearly uniform conditions at all times. New Zealand White rabbit was the experimental animal used, in which anesthesia was induced intraperitoneally to expose the mandibula. A hole was made in the mandibula, into which a small cotton pellet inoculated with Streptococcus milleri and Bacteroides fragilis, whose cell concentrations had been adjusted to 10(8)CFU/ml, was implanted and the opening was carefully closed with sutures tightly. These two species of bacteria had been selected because mixtures of gram-positive cocci and anaerobic bacteria have been isolated in most cases from the occluded abscess of oral cavity infections. As a result of the above procedure, it was found that one week after production of the infected model animal, the abscess contained adequate volume of, pus for collection and demonstrated viability of the two transplanted species of bacteria. This animal model was considered an ideal model for use in the studies on treatment of infections in the oral cavity by administering antimicrobial agents to determine the extent of drug transfer into the pus and bones where purulent foci are present.

Abscess↗
PubMed1988

Disturbances in dental development after total body irradiation in bone marrow transplant recipients.

The dental status of 16 children who had been treated with bone marrow transplantation (BMT) for serious bone marrow diseases was followed for up to 6 years. Several types of disturbances in dental development were observed in children who had been conditioned with total body irradiation (TBI) at 10 Gy before BMT. Thus, impaired root development that caused short V-shaped roots was found in all patients, a complete failure of root development and premature apical closure were found in five patients, enamel hypoplasia was observed in four patients, and microdontia was observed in three patients conditioned with TBI. Patients younger than 6 years of age at BMT exhibited the most severe and extensive dental aberrations. The TBI at 10 Gy appeared to be the major cause of the disturbances found.

Abnormalities, Radiation-Induced↗
PubMed1988

Effect of topical administration of vancomycin versus chlorhexidine on alpha-hemolytic streptococci in oral cavity.

In a crossover study the effect of local vancomycin (paste containing 0.5% vancomycin applied to the gums three times a day for 7 days) versus chlorhexidine mouth rinsing (0.2% chlorhexidine solution twice a day for 7 days) on alpha-hemolytic streptococci in the oral cavity was investigated in eight volunteers. Mixed saliva and dental plaque samples were collected for microbiologic analysis before administration, during treatment, and after withdrawal of the agents. The numbers of different alpha-hemolytic streptococci were determined in the samples. The total numbers of Streptococcus mitior, Streptococcus mutans, and Streptococcus sanguis were significantly reduced by the vancomycin treatment compared with the chlorhexidine treatment (p less than 0.05) after 2 days of administration. Two days after the treatment was stopped the numbers of alpha-hemolytic streptococci had returned to pretreatment levels. Local prophylaxis with vancomycin as a complement to systemic antimicrobial prophylaxis may therefore be useful in the prevention of infective endocarditis.

Administration, Topical↗